This is a proposal to complete the reporting of data relating to the recognition, response and long term adaptation to severe mental illness on the part of families of mental patients as reconstructed through interviews with the patient's spouse beginning soon after initial hospitalization and carried through the period of hospitalization. Data collected from more than 80 families in Washington, D.C. and Maryland suburbs in 1952-60 have been supplemented by two series of interviews with the spouses and patients in 1971-73, one obtained in the Washington area and the other in the San Francisco Bay Area. In addition, the falilies and patients seen in 1952-60 were followed up to assess factors influencing the long term impact of mental illness and hospitalization. The time span covered permits inferences as to how major changes in community mental health facilities have influenced the meaning and consequences of the patient's illness for his or her family. The analyses in process examine the ways in which the spouse's perception of the patient's mental disorder is influenced by the spouse's preexisting concept of the patient as a person, the nature of the marital relationship and the communication patterns sustaining that relationship, and the degree of change in behaviors from "normality" to manifestations of symptomatology just before admission. The spouse's efforts to cope with the patient's disruptive behaviors prior to hospitalization and to reconstitute the marital relationship in the first six months after the patient's return will also be delineated and differentiated in terms of multivariate analysis.